and how to manage!
There are many common reasons a child can become dehydrated.
- Illness especially vomiting and/or diarrhea or viruses that cause sore throat
- Not drinking enough age-appropriate liquids
- Exertion in the heat without proper hydration and/or rest
Signs of dehydration include:
Mild to moderate dehydration:
- Urinating less frequently (less urine in a potty-trained child or less diapers in a younger child)
- Parched, dry lips
- Fewer tears when crying
These symptoms would be in a child who is not drinking at their baseline or is losing fluids in some way (sweating on a hot day or vomiting/diarrhea). I oftentimes get parents worried of isolated situations of less wet diapers in an infant or toddler when they are otherwise in good spirits. This is not a concern so look at the big picture. Of course, in this situation, if they don’t urinate in 24 hours; seek medical attention.
The child is not drinking liquids or has vomiting/diarrhea or extreme heat exposure (check out this blog) and is:
- Very irritable
- Excessively sleepy
- Eyes are sunken
- Fontanelle (soft spot) is sunken in. Reminder: this may close in some toddlers
What to do if your child is dehydrated:
If your child is severely dehydration or you are uncertain, seek medical attention.
If your child has mild dehydration, focus on rehydrating them the following way:
- If your child is breastfed or formula-fed, continue giving them this. If the reasons for the dehydration is a stomach virus, start with small amounts (5-10ml) and build up. I discuss managing stomach viruses in this YouTube video. If your infant is not able to keep breastmilk or formula down, contact your pediatrician about Pedialyte. Pedialyte is okay over two months, but we would like to know if your child needs to be evaluated.
- If your child Is over one, focus on keeping them hydrated with the following options:
- Breastmilk if still breast-feeding (and following if not keeping up with hydration with breast milk)
- Pedialyte, Enfalyte, or store pediatric electrolyte solution (the electrolytes can help replenish electrolytes lost especially in vomiting-it contains a good balance of water, sugar, and salt). I am also okay with diluted Gatorade zero if you do not have access to Pedialyte (mix 1:1 with water).
- Popsicles (Pedialyte popsicles are great or anything with low sugar). Watch for popsicles with sorbitol as this can sometimes cause diarrhea and we don’t want to make things worse.
- As you see your child tolerating more liquids, you can advance to their normal liquids.
When a child is vomiting, they may lose sodium, potassium, and chloride which is why electrolyte solution are preferred. A child under 1 year with these symptoms should speak to a clinician.
Watch outs if your child becomes dehydrated:
- Don’t let them guzzle liquids especially if the dehydration is related to a stomach virus. This can overwhelm them and actually induce vomiting. Slow sips of 5-10 ml is best and advance as tolerated every 10-20 min.
- Your child can still eat if hungry, but start slow similar to liquids.
- Don’t give babies plain water, especially under 6 months. It can cause more electrolyte abnormalities.
- Don’t give sports drinks (that have sugar), soda, or undiluted juice. These have too much sugar and can make symptoms worse (jitteriness or stomachaches).
- Monitor urine or wet diapers. If they are not drinking anything for more than 3 hours of if the signs of dehydration are worsening, seek medical attention.